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An E. coli outbreak linked to tainted lettuce has sickened at least 19 people in Ohio, New York and Michigan, including students on at least two college campuses, prompting a recall throughout much of the country.

Freshway Foods of Sidney, Ohio, says it is recalling romaine lettuce sold in 23 states and the District of Columbia.

Federal health authorities say 12 of those sickened were hospitalized and three reported life-threatening symptoms. The CDC says it is looking at 10 other cases probably linked to the outbreak.

College students at Ohio State in Columbus and Daemen College in Amherst, N.Y., are among those affected, according to local health departments in those states. Nine of the 10 confirmed cases in Michigan were in Washtenaw County, where the University of Michigan is located. It could not be determined immediately, however, whether that school was affected.